Diabetes: An Introduction
What is diabetes?
It is having a higher level of glucose in your blood than your body can handle, but it’s not a simple case of eating too much sugar. Glucose is our main source of energy. We get glucose from the breakdown of carbohydrates (rice, potatoes, pasta/noodles, bread, cakes, fruits and vegetables).
How do you get diabetes?
Essentially diabetes occurs when there’s a breakdown in the transfer of glucose from the blood into the cells. Insulin, a chemical hormone produced by the pancreas, is needed for balanced uptake of glucose into the cells. Essentially, insulin acts as the gatekeeper to the pancreas. When blood glucose levels are high, insulin promotes cell uptake and the lack of insulin from reduced production or ineffective insulin (insulin resistance) effectively results in decreased glucose in the cells and excessive amounts in the blood. This imbalance results in the following symptoms:
- Lethargy: from lack of glucose in the cells
- Frequent urination: The kidneys try to remove the excess blood glucose
- Frequent thirst: a feedback of frequent passing of urine.
- Frequent eating: from sensation of lethargy
Types of diabetes:
Type 1: Juvenile onset, age.
Type 2: Usually age >40, in obese individuals, but increasingly found in younger people who are getting it too because of lifestyle related behavior and it is more common now.
Gestational: during pregnancy
Who’s at risk:
- Obese, inactive individuals
- Those with strong family history of diabetes (parents,siblings)
- Ladies who had diabetes during pregnancy
When to test:
- When you develop the above symptoms
- High BMI (body mass index)
- Family history
- Personal history of gestational diabetes
- Other chronic illnesses: high cholesterol, high blood pressure
- Age above 40
How to test:
- Random glucose test: 2 non fasting blood samples are taken on two separate occasions. A value of above 11.1 mmol/l is a diagnosis of diabetes.
- Fasting glucose: after fasting overnight, a single blood sample is taken. A value of more than 7.0 mmol/l is diagnostic of diabetes.
- Should the above 2 tests not be conclusive, then the following test would be done: glucose tolerance test. After fasting overnight, a blood sample is taken.Then the patient is asked to drink a standard glucose drink with 75 g of glucose. Blood test is repeated 2 hours later. 2 hour levels above 11.1 mmol is positive for diabetes, levels less than 7.8 mmols is normal, equivocal levels indicate impaired glucose tolerance.